Question: I have mail order with my current coverage and get most of my medication through that service. My prescription drug company is different for 2024. How do I handle that?

Answer; I find that many individuals are using mail order to get their maintenance medication. This 90-day supply is useful for many reasons, it can save time and money. When your insurance coverage changes, you must then think about the change to this convenient service.

Locally there are some pharmacies that offer to fill your medications for a 90-day supply and then mail them to you from the local pharmacy. If this is what is happening, you don’t have to change much, simply show the local pharmacy your new insurance card, so they know which insurance to run your medications through.

The question asked today, I believe has to do with traditional Mail Order Medication procedures.

Each Insurance Company, or Prescription Drug Plan has its own procedure for using Mail Order. There are hundreds of mail order pharmacies, many of them owned by insurance companies. So when you switch from one insurance carrier to another, you may have to change your mail order company. Often your Part D plan has one particular Mail Order Company they deal with.

In 2024 if your insurance coverage is through Wellcare you may be changing your mail order service because Wellcare is moving to Express Scripts mail order company for all their products. In this situation, your insurance company, Wellcare will be sending you new insurance cards with Express Scripts contact information on the back and new material explaining how to make this change.

For those individuals that signed up for new insurance, you will receive a whole packet of information and your answer is in that packet. Buried in that booklet of information about your insurance coverage is how the company would like you to handle your mail order option when filling your medications.

If you can’t find that book, threw it out, or simply can’t find the information in the book, look at your insurance card. On the back of the card is a list of numbers to call for different concerns. One of them may be customer service, prescription drug questions, or a name like that. This is the number you can call to ask questions. The customer service department will explain how they handle getting started with your mail order medications.

You will also need to talk with your doctor’s office staff. The doctor’s office must have your Prescription Drug Coverage in their system, so you need to show them the new card you just got. Once your physician’s office has the prescription drug coverage information, your ID number and the insurance company contact information they can inform the company what you take and begin the process to get your medications mailed to you.

You will need to call the mail order pharmacy after your physician sends your prescriptions. You will need to tell them to fill these prescriptions and make sure they have your correct information, where you live, what is your name, Date of Birth, ID #, contact information, etc. Once you contact the mail order company and confirm you want the medications, they will fill your prescriptions and mail them to your address on record. The refill information will come along with your medications instructing you how to refill them. This can usually be done on-line or with a phone call. This process may require that you give them credit card information to bill your medication through. You can decide if that system works for you. Some mail order companies will allow you to be billed and then you can send payment back to them once the medications are received.

Getting your medications using the mail order method may work very well for you. It often saves your money on the cost of your medications, and you don’t have to fill your medications as often. The shipment of medications can be sent to different addresses, depending on where you are when you need them.

One of the downsides to many mail order pharmacies is that they don’t or can’t bill your medications through EPIC. EPIC is the New York State Elderly Pharmaceutical Insurance Coverage Program available to seniors who live in New York State, have Prescription Drug Coverage and make less than $75,000 a year as a single person or $100,000 for a married couple.

EPIC would be secondary coverage to your Part D (Prescription Drug) Plan. If your medications are expensive, EPIC could save your money on your co-pays. If you use mail order, the medications are often coming from other states, so your medications might not be billed through this New York State benefit. Once you know your mail order pharmacy, you can call EPIC and see if they have a contract with that company. EPIC may, as they are collaborating with more and more companies all the time.

A downside to the mail order process is that you will lose that face to face contact you may get with the pharmacist as your local pharmacy. This face to face contact is an opportunity to ask questions about your medications, or interactions between your medications. The mail order company does have pharmacists you can call and talk with to ask questions.

You may choose to use both mail order and the local pharmacy. You don’t have to do all or nothing. You can get some from the local pharmacy and some from Mail Order. Look over the information sent to you and make your own decision based on what works best for you. Just be sure to let your pharmacists know that your insurance coverage has changed.

Let’s all work together to make 2024 great!

Janell Sluga is a Geriatric Care Manager helping seniors in our community access services and insurance. To reach her, please email editorial@post-journal.com.